HESI Maternity OB Exam 2025 – Versions 1
and 2 + Practice Test | Actual Questions
with 100% Verified Answers and
Rationales | 110 + Q & A
Labor Stages (25 Questions)
Question 1: Multiple-Choice
A client in the first stage of labor has contractions every 5 minutes, lasting 60 seconds. What is
the priority nursing action?
A. Encourage ambulation
B. Monitor fetal heart rate (FHR)
C. Administer pain medication
D. Prepare for immediate delivery
Correct Answer: B
Rationale: Monitoring FHR (B) assesses fetal well-being during active labor. Ambulation (A)
may be encouraged but is secondary, pain medication (C) depends on client preference, and
delivery (D) is premature in the first stage.
Question 2: Select-All-That-Apply
Which findings indicate the active phase of the first stage of labor? (Select all that apply.)
A. Cervical dilation of 6 cm
B. Contractions every 2–3 minutes
C. Mild discomfort relieved by walking
D. Cervical effacement of 80%
Correct Answers: A, B, D
Rationale: Active phase is characterized by cervical dilation of 4–7 cm (A), frequent
contractions (B), and significant effacement (D). Mild discomfort (C) is typical of the latent
phase.
Question 3: Multiple-Choice
A client is in the second stage of labor. Which position facilitates delivery?
A. Supine with legs elevated
B. Lithotomy with head elevated
,C. Hands-and-knees position
D. Left lateral position
Correct Answer: B
Rationale: The lithotomy position (B) facilitates delivery by opening the pelvis. Supine (A) risks
aortocaval compression, hands-and-knees (C) aids labor but not delivery, and lateral (D) is for
resting.
Question 4: Case Study (Drag-and-Drop)
Scenario: A client in the first stage of labor reports increasing pain and anxiety.
Question: Place the nursing interventions in order of priority.
A. Teach breathing techniques
B. Assess FHR and contraction pattern
C. Administer prescribed analgesia
D. Reassess pain level
Correct Answer: 1. B, 2. A, 3. C, 4. D
Rationale: Assessing FHR and contractions (B) ensures fetal safety, teaching breathing (A)
manages pain non-pharmacologically, analgesia (C) follows if needed, and reassessing pain (D)
evaluates effectiveness.
Question 5: Multiple-Choice
A client in the third stage of labor has a firm uterus but continued bleeding. What should the
nurse suspect?
A. Uterine atony
B. Cervical laceration
C. Retained placenta
D. Endometritis
Correct Answer: B
Rationale: Continued bleeding with a firm uterus (B) suggests a cervical laceration. Uterine
atony (A) causes a boggy uterus, retained placenta (C) causes persistent bleeding with placental
signs, and endometritis (D) occurs postpartum.
Question 6: Multiple-Choice
During the second stage of labor, a client reports a strong urge to push. What should the nurse
do?
A. Discourage pushing until fully dilated
B. Encourage pushing with contractions
C. Administer oxygen immediately
D. Notify the provider of fetal distress
Correct Answer: B
Rationale: An urge to push in the second stage indicates full dilation; encouraging pushing (B)
is appropriate. Discouraging pushing (A) delays delivery, oxygen (C) is unnecessary without
distress, and notification (D) is premature.
, Question 7: Select-All-That-Apply
Which interventions are appropriate during the third stage of labor? (Select all that apply.)
A. Massage the fundus if boggy
B. Administer oxytocin as ordered
C. Encourage immediate breastfeeding
D. Assess for cervical dilation
Correct Answers: A, B, C
Rationale: Fundal massage (A), oxytocin (B), and breastfeeding (C) promote uterine contraction
and placental expulsion. Cervical dilation (D) is irrelevant post-delivery.
Question 8: Multiple-Choice
A client in the transition phase of labor reports nausea. What is the priority nursing action?
A. Administer an antiemetic
B. Provide a cool washcloth
C. Assess FHR
D. Encourage sips of water
Correct Answer: C
Rationale: Nausea may indicate fetal distress; assessing FHR (C) is the priority. Antiemetics
(A), washcloths (B), and fluids (D) are secondary.
Question 9: Multiple-Choice
What is the expected cervical dilation rate in the active phase of labor for a primigravida?
A. 0.5 cm/hour
B. 1 cm/hour
C. 2 cm/hour
D. 3 cm/hour
Correct Answer: B
Rationale: Primigravidas dilate at approximately 1 cm/hour (B) in the active phase. Other rates
(A, C, D) are incorrect for primigravidas.
Question 10: Multiple-Choice
A client in the second stage of labor has prolonged pushing. What should the nurse assess?
A. Maternal blood pressure
B. FHR variability
C. Cervical effacement
D. Contraction intensity
Correct Answer: B
Rationale: Prolonged pushing may stress the fetus; assessing FHR variability (B) monitors fetal
well-being. Blood pressure (A), effacement (C), and contractions (D) are secondary.
Question 11: Multiple-Choice
and 2 + Practice Test | Actual Questions
with 100% Verified Answers and
Rationales | 110 + Q & A
Labor Stages (25 Questions)
Question 1: Multiple-Choice
A client in the first stage of labor has contractions every 5 minutes, lasting 60 seconds. What is
the priority nursing action?
A. Encourage ambulation
B. Monitor fetal heart rate (FHR)
C. Administer pain medication
D. Prepare for immediate delivery
Correct Answer: B
Rationale: Monitoring FHR (B) assesses fetal well-being during active labor. Ambulation (A)
may be encouraged but is secondary, pain medication (C) depends on client preference, and
delivery (D) is premature in the first stage.
Question 2: Select-All-That-Apply
Which findings indicate the active phase of the first stage of labor? (Select all that apply.)
A. Cervical dilation of 6 cm
B. Contractions every 2–3 minutes
C. Mild discomfort relieved by walking
D. Cervical effacement of 80%
Correct Answers: A, B, D
Rationale: Active phase is characterized by cervical dilation of 4–7 cm (A), frequent
contractions (B), and significant effacement (D). Mild discomfort (C) is typical of the latent
phase.
Question 3: Multiple-Choice
A client is in the second stage of labor. Which position facilitates delivery?
A. Supine with legs elevated
B. Lithotomy with head elevated
,C. Hands-and-knees position
D. Left lateral position
Correct Answer: B
Rationale: The lithotomy position (B) facilitates delivery by opening the pelvis. Supine (A) risks
aortocaval compression, hands-and-knees (C) aids labor but not delivery, and lateral (D) is for
resting.
Question 4: Case Study (Drag-and-Drop)
Scenario: A client in the first stage of labor reports increasing pain and anxiety.
Question: Place the nursing interventions in order of priority.
A. Teach breathing techniques
B. Assess FHR and contraction pattern
C. Administer prescribed analgesia
D. Reassess pain level
Correct Answer: 1. B, 2. A, 3. C, 4. D
Rationale: Assessing FHR and contractions (B) ensures fetal safety, teaching breathing (A)
manages pain non-pharmacologically, analgesia (C) follows if needed, and reassessing pain (D)
evaluates effectiveness.
Question 5: Multiple-Choice
A client in the third stage of labor has a firm uterus but continued bleeding. What should the
nurse suspect?
A. Uterine atony
B. Cervical laceration
C. Retained placenta
D. Endometritis
Correct Answer: B
Rationale: Continued bleeding with a firm uterus (B) suggests a cervical laceration. Uterine
atony (A) causes a boggy uterus, retained placenta (C) causes persistent bleeding with placental
signs, and endometritis (D) occurs postpartum.
Question 6: Multiple-Choice
During the second stage of labor, a client reports a strong urge to push. What should the nurse
do?
A. Discourage pushing until fully dilated
B. Encourage pushing with contractions
C. Administer oxygen immediately
D. Notify the provider of fetal distress
Correct Answer: B
Rationale: An urge to push in the second stage indicates full dilation; encouraging pushing (B)
is appropriate. Discouraging pushing (A) delays delivery, oxygen (C) is unnecessary without
distress, and notification (D) is premature.
, Question 7: Select-All-That-Apply
Which interventions are appropriate during the third stage of labor? (Select all that apply.)
A. Massage the fundus if boggy
B. Administer oxytocin as ordered
C. Encourage immediate breastfeeding
D. Assess for cervical dilation
Correct Answers: A, B, C
Rationale: Fundal massage (A), oxytocin (B), and breastfeeding (C) promote uterine contraction
and placental expulsion. Cervical dilation (D) is irrelevant post-delivery.
Question 8: Multiple-Choice
A client in the transition phase of labor reports nausea. What is the priority nursing action?
A. Administer an antiemetic
B. Provide a cool washcloth
C. Assess FHR
D. Encourage sips of water
Correct Answer: C
Rationale: Nausea may indicate fetal distress; assessing FHR (C) is the priority. Antiemetics
(A), washcloths (B), and fluids (D) are secondary.
Question 9: Multiple-Choice
What is the expected cervical dilation rate in the active phase of labor for a primigravida?
A. 0.5 cm/hour
B. 1 cm/hour
C. 2 cm/hour
D. 3 cm/hour
Correct Answer: B
Rationale: Primigravidas dilate at approximately 1 cm/hour (B) in the active phase. Other rates
(A, C, D) are incorrect for primigravidas.
Question 10: Multiple-Choice
A client in the second stage of labor has prolonged pushing. What should the nurse assess?
A. Maternal blood pressure
B. FHR variability
C. Cervical effacement
D. Contraction intensity
Correct Answer: B
Rationale: Prolonged pushing may stress the fetus; assessing FHR variability (B) monitors fetal
well-being. Blood pressure (A), effacement (C), and contractions (D) are secondary.
Question 11: Multiple-Choice
